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目的分析眼睑恶性肿瘤的临床病理类型和治疗方法。方法对74例眼睑恶性肿瘤患者进行病例回顾性分析。其中,男性35人,女性39人,肿瘤部位:右眼38人,左眼36人,上睑25人,下睑49人,年龄28岁～84岁,平均60.74岁。病理诊断示:基底细胞癌39例,睑板腺癌22例,鳞状上皮细胞癌7例,恶性黑色素瘤4例,小细胞癌1例,小细胞恶性淋巴瘤1例。均采用手术治疗,其中6例因肿瘤侵及眶内,行眶内容剜出术,其余病例皆手术切除肿瘤,于术中送冰冻切片控制切缘(Mohs法)以保证术中完全切除肿瘤组织。眼睑缺损一期手术修复。结果6例行眶内容剜出术患者术后遗留明显的眼眶畸形,须二期行眼眶赝复或眼眶畸形整复术。68例术后眼睑外观满意,视功能无影响。结论眼睑恶性肿瘤多发生于老年人,其中基底细胞癌居第一位,其次为睑板腺癌,鳞状上皮细胞癌占第三位。治疗为手术切除加一期缺损修复,睑板结膜瓣滑行修复眼睑缺损具有操作方便、术后眼睑外形满意的优点。
Objective To analyze the clinicopathological types and treatment of malignant eyelid tumors. Methods 74 patients with eyelid malignancies were retrospectively analyzed. Among them, 35 were males and 39 were females. The tumor site was 38 in the right eye, 36 in the left eye, 25 in the upper eyelid, and 49 in the lower eyelid. The average age was 60.74 years. Pathological diagnosis showed basal cell carcinoma in 39 cases, meibomian gland carcinoma in 22 cases, squamous cell carcinoma in 7 cases, malignant melanoma in 4 cases, small cell carcinoma in 1 case and small cell lymphoma in 1 case. All of them were surgically treated. Among them, 6 cases had tumor invasion and intraorbital orbital contents. The remaining cases underwent surgical resection of the tumor. Frozen sections were treated by Mohs method to ensure complete resection of tumor tissues . Eyelid defect surgery repair. Results 6 cases of orbital content 剜 out of patients with obvious orbital deformity after surgery, to be two orbital prosthesis or orbital deformity plastic surgery. 68 cases of eyelid appearance satisfactory, no effect of visual function. Conclusion Eyelid malignancies occur in the elderly, of which basal cell carcinoma ranks first, followed by meibomian gland carcinoma, squamous cell carcinoma third. Treatment for surgery plus a defect repair, tarsal conjunctival flap sliding repair eyelid defect with easy operation, postoperative eyelid appearance of the merits.